Rapid identification of high-risk patients after minor head trauma (MHT) by assessment of S-100B: ascertainment of a cut-off level.

BACKGROUND: Elevated blood S-100B levels were described by several authors for reliable identification of patients with intracerebral complications after minor head trauma (MHT). Yet, test systems used so far require more than 3 hours processing period which is too long to enable immediate further diagnostic or therapeutic consequences. Therefore we validate a new rapid test version for S-100B measurements and established an effective cut-off level to identify high risk patients. METHODS: 104 patients suffering from MHT were enrolled. After taking blood samples S-100B values were achieved by the long-term and rapid (40 min processing time) test system, respectively, and compared using linear regression analysis. For determination of an effective cut-off level receiver operating characteristics curves were calculated in accordance with cranial computed tomography findings. RESULTS: S-100B concentrations correlated significantly using both test systems. A cut-off level of 0.18ng/ml was calculated in plasma samples. CONCLUSIONS: S-100B concentrations above the cut-off level measured within 40 min after blood sampling allows safe identification and immediate treatment of intracerebral lesions (e.g. epidural and subdural hematoma, subarachnoid hemorrhage, diffuse brain edema etc.) in MHT patients.